Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1183601 | TX |
NPI | 1063867281 |
---|---|
Provider Name | Melissa D Kiefer |
First Address | Allen, TX 75013-8131 |
Second Address | Allen, TX 75013-8131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2016 |
Last Update Date | 25/04/2016 |